Delirium and functionality: The impact of delirium on the level of functioning
| Autor: | William Breitbart, Susanne Boettger, Josef Jenewein, Soenke Boettger |
|---|---|
| Přispěvatelé: | University of Zurich, Boettger, Susanne |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
KPS
medicine.medical_specialty 610 Medicine & health behavioral disciplines and activities 2738 Psychiatry and Mental Health Internal medicine mental disorders medicine Dementia Functionality Performance status MDAS Confounding Delirium Cancer Hypoxia (medical) medicine.disease Level of functioning nervous system diseases Psychiatry and Mental health Impact 10057 Klinik für Konsiliarpsychiatrie und Psychosomatik Anesthesia Etiology medicine.symptom Psychology Brain metastasis |
| Zdroj: | The European Journal of Psychiatry, Volume: 28, Issue: 2, Pages: 86-95, Published: JUN 2014 The European Journal of Psychiatry v.28 n.2 2014 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname |
| Popis: | Background and Objectives: Studies have shown showed that delirium af- fects the long-term functional status, however, the acute effect of delirium on functioning has been less documented. The purpose of this analysis was to examine the acute impact of delirium on the level of functioning. Methods: All patients were recruited at the Memorial Sloan Kettering Cancer Center (MSKCC). The Memorial Delirium Assessment Scale (MDAS) and Karnofsky scale of Performance Status (KPS) were recorded at baseline (T1), 2-3 days (T2) and 4-7 days (T3). A secondary analysis in respect to sociodemographic and medical variables, aspects of delirium, and level of functioning was performed. Results : Delirium severity at baseline did not affect the level of functioning, however, re- solved delirium resulted in substantial functional recovery compared to persistent delirium at T2 (30.2 and 23.5) and T3 (35.1 and 26.2). Patients with persistent functional impairment were not different in age, pre-existing dementia or brain metastasis compared to those with functional recovery. However, brain cancer, terminal illness, hypoxia and multiple etiolo- gies caused persistent functional decline. Although delirium severity was not different at baseline, delirium was more severe in the functionally-impaired at T2 and T3. Similarly, delirium resolution was inferior in these patients in contrast to the functionally-recovered at T2 (25% and 65.4%) and T3 (62.5% and 83.3%). On the contrary, the duration of delirium affected functional recovery; shorter delirium predicted faster functional recovery. Conclusions: Delirium caused an acute functional decline and appropriate management of delirium with antipsychotics reversed this decline. On the contrary, shorter duration of deliri- um was associated with faster functional recovery. Brain cancer, terminal illness, hypoxia, and multiple etiologies were confounders for persistent delirium and functional impairment. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|